〔Abstract〕 Objective To investigate the effect of electroacupuncture (EA) Knee Tri-acupuncture on knee osteoarthritis(KOA) rats and the expression of Toll-like receptor 4，(TLR4) and nuclear factor κBp65 (NF-κBp65). Methods A total of 76 patients with CHD and tachyarrhythmia diagnosed and treated in Pingdingshan Hospital of Traditional Chinese Medicine from July 2020 to December 2022 were selected and divided into a control group and an observation group according to random number table method, with 38 cases in each group. The control group was treated with metoprolol according to the conventional treatment plan, and the observation group was treated with Yangxin Yiqi Tongmai decoction combined with metoprolol. The clinical efficacy, traditional chinese medicine syndrome score, hemorheology index and occurrence of adverse reactions were compared between the two groups. Results Moran score in the model group was significantly lower than that in the control group, while Mankin score was significantly higher than that in the control group . Moran scores in electroacupuncture group and celecoxib group were significantly higher than those in model group, while Mankin score were significantly lower than those in the control group. The expression levels of TLR4, p-NF-κBp65, IL-6 and TNF-α in the model group were significantly higher than those in the control group, while the expression levels of TLR4, p-NF-κBp65, IL-6 and TNF-α in the electroacupuncture and celecxib groups were significantly lower than those in the model group. Conclusion EA Knee Tri-acupuncture can reduce the cartilage destruction and delay the degeneration of articular cartilage in the rat model of KOA, which may be related to its effects in down-regulating the levels of TLR4 and p-NF-κBp65 and reduce the release of inflammatory factors IL-6 and TNF-α.